Abstract: Objective To study the relationship between cord blood miR-431 and congenital hearing disorders in neonates, so as to provide reference for clinical prevention and treatment of congenital hearing impairment. Methods From May 2017 to June 2019, 80 neonates with congenital hearing disorder admitted to the Department of Obstetrics and Gynecology, Pidu District People′s Hospital were enrolled as case group, while another 30 neonates with normal hearing were selected into normal group. The threshold of auditory brainstem response(ABR) test, and expression levelsof cord blood miR-431, miR-183 and miR-96 were compared between the two groups. The identification value of miR-431 and miR-183 for mild, moderate and severe hearing disorder was analyzed by ROC curve. Results After click, thresholds of left and right ears in ABR test in case group were significantly higher than those in normal group(t=22.166, 19.741, P<0.05). The miR-431 level in case group was significantly higher than that in normal group, while miR-183 level was significantly lower than that in normal group(t=15.445, 19.607, P<0.05). The miR-431 level in severe hearing disorder group was significantly higher than that in mild-to-moderate hearing disorder group, while miR-183 level was significantly lower than that in mild-to-moderate hearing disorder group(t=10.047,11.816,P<0.05). When the cut-off value of miR-431 was 0.48, the area under the curve(AUC) in discriminating mild, moderate and severe hearing disorder was 0.835(95%CI: 0.735 - 0.908, P<0.001).The sensitivity and specificity were 77.78% and 86.36%, respectively. When the cut-off value of miR-183 was 0.25, the area under the curve(AUC) in discriminating mild, moderate and severe hearing loss was 0.804(95%CI: 0.700 - 0.884, P<0.001).The sensitivity and specificity were 72.22% and 84.09%, respectively. Conclusions The left and right ear ABR thresholds of newborns with congenital hearing disorder are significantly higher than those of normal neonates, while the expression level of miR-431 in cord blood is abnormally up-regulated, while expression level of miR-183 is down-regulated. The miR-431 and miR-183 have better efficacy in discriminating mild, moderate and severe hearing disorder.

Key words: cord blood, miR-431, congenital hearing disorder, neonate

摘要： 目的 分析脐带血miR-431表达水平与新生儿先天性听力障碍的关系,为先天性听力障碍的临床防治提供参考依据。方法 选取2017年5月—2019年6月成都市郫都区人民医院耳鼻喉科收治的80例先天性听力障碍新生儿作为病例组,另外同期选取30例听力正常新生儿作为正常组。比较两组新生儿听性脑干反应(ABR)测试阈值和脐带血miR-431、miR-183、miR-96表达水平,采用ROC曲线分析脐带血miR-431、miR-183水平对轻中、重度听力障碍的鉴别价值。结果 短声产生后病例组左、右耳ABR测试阈值均明显高于正常组(t=22.166、19.741,P＜0.05);病例组患儿的miR-431水平明显高于正常组,miR-183水平明显低于正常组(t=15.445、19.607,P＜0.05);重度组患儿miR-431水平明显高于轻中度组,miR-183水平明显低于轻中度组(t=10.047、11.816,P＜0.05);miR-431鉴别轻中、重度听力障碍的曲线下面积(AUC)为0.835(95%CI:0.735~0.908,P＜0.001),界值为0.48,敏感度与特异度为77.78%、86.36%;miR-183鉴别轻中、重度听力障碍的AUC为0.804(95%CI:0.700~0.884,P＜0.001),界值为0.25,敏感度与特异度为72.22%、84.09%。结论 先天性听力障碍新生儿的左、右耳ABR阈值明显高于正常儿童,同时患儿脐带血miR-431表达异常上调,miR-183表达水平下调,且miR-431、miR-183具有较好地鉴别轻中、重度听力障碍的效能。

关键词: 脐带血, miR-431, 先天性听力障碍, 新生儿